The initiative to develop a National Health Insurance Plan was implemented in September 2002 when a Blue Ribbon Commission was appointed by PM (Perry) Christie “to review and make recommendations to the Government of the Bahamas on the feasibility of establishing a NHI plan for the delivery of quality healthcare to the Bahamian population that was cost effective and sustainable.”
This followed a similar initiative (1984-1986) when a Blue Ribbon Commission was appointed by PM Pindling to review plans to develop a NHI system. That Commission determined that the NHI cost was prohibitive and not sustainable in the local economy.
The basic research and framework for the current NHI plan focused on Primary Care and was developed between 2002-2007 and launched in April 2017 by PM Christie.
This NHI plan is seen as the beginning of a process towards Universal Health Care that will require continued review and refinement in the ensuing years recognizing the changing population demographics and the economy of The Bahamas.
Today, nearly 90,000 eligible Bahamians have registered with the NHI plan and a majority have expressed satisfaction with the primary care service provided.
The Primary Care Transformation Initiative (PCTI) is a step along the road of developing a more efficient and effective primary care system and will require the support of all stakeholders.
Prior efforts during the development phase to create a more comprehensive NHI plan were thwarted by vested interests and lobbies representing many senior Physicians, Insurance carriers and the Business community.
The stated four primary objectives are necessary elements to achieve the stated goals and no doubt will be met with opposition and pushback from vested interests.
- Assurance of Patient Confidentiality will be a source of great concern for many.
- Electronic Health Record portability between public and private physicians and institutions is necessary.
- The Physical condition and Staffing of public facilities remain a major challenge and must be addressed with urgency.
- Access to Private healthcare and private healthcare resources will need to be clarified and reimbursement for such services will need to be negotiated and agreed on.
- Availability to Off-shore specialist referrals will be of concern to many.
- Inclusion of Dental healthcare is necessary in primary healthcare coverage.
- Synchronization of basic health care coverage (Standard Health Benefit) with private Insurance carriers will present challenges.
Resolution of these challenges will require calm, considered and skilled negotiations that are viewed by stakeholders as being in the interest of the Bahamian population and must not be poisoned by partisan political interest and political timelines.
The Health and Wealth of this nation is dependent on achieving an acceptable balance of interests that is favourable to all stakeholders most particularly the people of The Bahamas.
~ Dr. Marcus Bethel, MD